This protocol applies to patients with follicular thyroid cancer who have a prior diagnosis of distant metastasis, or who present with bilateral thyroid tumors. These findings define a higher-risk sub-population with specific surgical and systemic management implications.
Total thyroidectomy is performed in patients with a prior diagnosis of distant metastasis or bilateral thyroid tumors suitable for surgery. The presence of either condition is the key factor that shapes the management approach for this patient group.
Systemic therapy in this setting may involve multi-tyrosine kinase inhibitor therapy. In tumors with specific molecular alterations, targeted agents are used instead — the selection determined by the molecular finding present.